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Initial illness severity may predict cardiac arrest outcome
Rittenberger J. Resuscitation. 2010; doi:10.1016/j.resuscitation.2011.06.024
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A newly developed illness severity score may aid in predicting outcomes for patients after cardiac arrest.
Researchers in the US used retrospective review data to developed an early, novel post-arrest illness severity score to predict survival, good outcome and development of multiple organ failure (MOF) after cardiac arrest.
Data available for analysis were from 457 adults who had been treated for an in-hospital or out-of-hospital cardiac arrest between Jan. 1, 2005 and Dec. 31, 2009.
Serial organ function assessment and full outline of unresponsiveness scores were evaluated along with clinical data to paint a portrait of initial illness severity. The primary outcome measures included mortality, good outcome (defined as discharge to home or rehabilitation) and development of multiple organ failure.
After univariate and multivariate analysis of the scales and subscales were conducted, four distinct categories of illness severity were created:
- Awake
- Moderate coma without cardiorespiratory failure
- Moderate come with cardiorespiratory failure
- Severe coma
An independent association between survival and category was observed. For the first category, the OR was 58.65 (95% CI, 27.78-123.82); for the second, the OR was 14.60 (95% CI, 7.34-29.02); and for the third, the OR was 10.58 (95% CI, 4.86-23.00).
An association also was observed between good outcome and development of multiple organ failure. It was noted that the proportion of patients in each category changed over time, according to the results.
“Initial illness severity explains much of the variation in cardiac arrest outcome,” the researchers wrote. “This model provides prognostic information at hospital arrival and may be used to stratify patients in future studies.”
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